May 2014, Vol 3, No 3

The Full Spectrum of Knowledge Driving Personalized Medicine

Dear Colleague, One of the fascinating aspects of personalized medicine is the recognition of how each component relates to all other components. Take this month’s “The Last Word” column, where one of healthcare’s premier policy authorities, Kip Piper, weighs in on the impact of the Affordable Care Act on cancer [ Read More ]

Darren Sigal, MD

Letter to Our Readers

JAK2 V617F in a Patient With AML

PMO is pleased to offer the department “The Biomarker” to discuss the identification of biomarkers in patients with cancer and the prognostic/predictive impact and clinical decision-making implications of that marker. Do you have a unique case to share with our reading community? Please submit your biomarker-driven cases to us at [ Read More ]


A Breakthrough Treatment for ALL and CLL: The New Biologic Agent, CTL019

An Interview With David L. Porter, MD, of the University of Pennsylvania

David L. Porter, MD, is Jodi Fisher Horowitz Professor in Leukemia Care Excellence in the Perelman School of Medicine at the University of Pennsylvania; and Director, Blood and Marrow Transplantation at the Abramson Cancer Center.The number of patients was small and the therapy still investigational, but the results of research [ Read More ]

Kristin Siyahian

Interview with the Innovators

Anti–PD-1/PD-L1 Therapy: New Immunotherapy Options for Patients With a Variety of Cancers

Sangmee Bae, MD, is a Resident in the Internal Medicine Department at the Ronald Reagan UCLA Medical Center in Los Angeles, California. Bartosz Chmielowski, MD, PhD, is Clinical Assistant Professor in the Division of Hematology and Medical Oncology of the University of California at Los Angeles. He specializes in the [ Read More ]

Sangmee Bae, MD


Perspectives on the Landscape of Personalized Medicine

An Interview with Gail E. Herman, MD, PhD; Barbara L. McAneny, MD; and Charles L. Sawyers, MD

Gail E. Herman, MD, PhD, is President of the American College of Medical Genetics and Genomics (ACMG).Barbara L. McAneny, MD, is Chief Executive Officer of New Mexico Cancer Center, New Mexico Oncology Hematology Consultants, Ltd.Charles L. Sawyers, MD, is Chair of the Human Oncology & Pathogenesis Program at Memorial Sloan [ Read More ]

Gail E. Herman, MD, PhD

Interview with the Innovators

A Win for Pediatric Cancer Research: The Gabriella Miller Kids First Research Act and Smashing Walnuts Foundation

On April 3, 2014, President Obama signed the Gabriella Miller Kids First Research Act. This act was introduced last year by representatives Peter Welch (D-VT) and Gregg Harper (R-MS) and strongly supported by House Majority Leader Eric Cantor (R-VA). After being introduced, the bill was renamed to include the name [ Read More ]

Pediatric Oncology

Promise of Personalized Care Hinges on Reimbursement Reform: Oncologists Must Lead the Way

The promise of big data-driven personalized healthcare mandates reform of the oncology reimbursement system, suggested Jeffery C. Ward, MD, medical oncologist, Swedish Cancer Institute, Edmonds, WA, in a recent commentary (Ward JC. J Oncol Pract. 2014;10:83-86). Oncologists must take the lead in moving past “medicine’s dark secret” of fee-for-service (FFS) [ Read More ]

Charles Bankhead

Value-Based Cancer Care

14 New Genetic Markers Predict Risk for Prostate Cancer

A mutation in any one of a suite of DNA repair pathway genes may predict not only the risk for familial prostate cancer but also indicate the presence of a particular aggressive form of the disease, according to results of a new UK study from the Institute of Cancer Research [ Read More ]

Neil Canavan


Routine Cervical Cancer Screening Warranted Beyond Age 64

Results of a new study investigating the probability of a cervical cancer diagnosis among women aged 65 to 83 years using data from the UK Cervical Screening Call/Recall System indicate that the current practice may need to be changed. The new data show that the odds of such a diagnosis [ Read More ]

Rosemary Frei, MSc


New Melanoma Guideline Adds BRAF Inhibitor, MEK Inhibitor to First-Line Systemic Therapy Options

The BRAF inhibitor dabrafenib has been added as a category 1 recommendation for the primary treatment of BRAF-mutated metastatic melanoma in the latest version of the National Comprehensive Cancer Network (NCCN) guidelines. MEK inhibition with trametinib in BRAF-mutated melanoma was also added to the systemic therapy options for the treatment [ Read More ]

John A. Thompson, MD


The Affordable Care Act: Where Are We Now, What’s the Future?

The Affordable Care Act (ACA) is in its infancy, but it is already changing oncology practice, said panelists during a roundtable discussion at the 2014 meeting of the National Comprehensive Cancer Network (NCCN). The changing composition of oncology patients, the risk pool of the exchanges, new payment and reimbursement models, [ Read More ]


Therapy for Castration-Resistant Prostate Cancer: Use Disease State as the Guide

Understanding the clinical disease states is essential when choosing therapy for patients with castration-resistant prostate cancer (CRPC), said Celestia S. Higano, MD. Patients with castration-resistant disease can be divided into those with metastatic disease and those with nonmetastatic disease. The focus of her presentation was on therapeutic options for metastatic [ Read More ]


Molecular Monitoring Can Provide Treatment Guidance in CML

Monitoring molecular response to tyrosine kinase inhibitor (TKI) therapy for chronic myelogenous leukemia (CML) may help guide the decision to switch therapy and the timing of progression to second- and third-line therapy, said Jerald P. Radich, MD, at the 2014 meeting of the National Comprehensive Cancer Network (NCCN). Response rates [ Read More ]


Treatment Paradigm for NSCLC May Be Shifting

Driver mutations, most commonly KRAS and EGFR, account for about half of non–small cell lung cancer (NSCLC), and this recognition is shifting the NSCLC treatment paradigm toward targeted therapy when possible, said Leora Horn, MD, MSc. In the future, immunotherapy may play a significant role in the NSCLC treatment armamentarium. [ Read More ]


Investigational Angiogenesis Inhibitor Improves Survival as Second-Line Treatment in Gastric Cancer

Phase 3 data from a global study indicated an improvement in overall survival (OS) when the investigational angiogenesis inhibitor ramucirumab was added to chemotherapy as second-line therapy in patients with advanced gastric cancer. The improvement in survival was more than 2 months with ramucirumab when used after progression on first-line [ Read More ]


It’s About Time: Monoclonal Antibodies for Multiple Myeloma

Within the oncology drug development pipeline, “multiple myeloma is one of the more intriguing spaces,” according to R. Donald Harvey, PharmD, who said one reason for his excitement is the emergence of monoclonal antibodies. Harvey, associate professor of hematology/oncology at Emory University, Atlanta, GA, and director of the Phase I [ Read More ]


The Affordable Care Act and Cancer Patients – Winners and Losers in an Unsteady Paradigm Shift: Part 2 The Conclusion of an Analysis of the ACA by Kip Piper, MA, FACHE

In the April issue of PMO, Mr Kip Piper, a leading healthcare policy authority, addressed the benefits of the Affordable Care Act (ACA) for cancer patients and oncologists. In this second report, he addresses the problems the ACA presents. For the ACA’s sword does indeed cut both ways, particularly in [ Read More ]